Publication:

An observational study of the effect of escitalopram and etizolam in type 2 diabetes mellitus patients with depression

Background Past decades have witnessed a rapid rise in the prevalence of diabetes mellitus; estimated to affect 415 million adults worldwide and 69.1 million adults in India. There has been an increased prevalence of diabetes associated depression, which can aggravate the symptoms of depression and diabetes associated complications. Use of tricyclic antidepressants (TCA) can disturb the glycemic control. Escitalopram is a selective serotonin reuptake inhibitor (SSRI) and Etizolam is a new safe antianxiety agent. The objective of this study was to study the prevalence of depression and anxiety in type 2 diabetes mellitus patients and to assess the efficacy of escitalopram and etizolam in the treatment of depression and/or anxiety in type 2 diabetes mellitus patients.

Methods Total 125 patients diagnosed with type 2 diabetes mellitus with fulfilling the inclusion and exclusion criteria were included in the study. Informed written consent was obtained from the patients willing to participate in the study. They were screened for the presence of depression with the help of PHQ-9. Their demographic features were recorded and initial laboratory investigations done. Haemogram, blood sugar level - fasting (BSL-F) and postprandial (PP), serum alanine transferase (ALT), serum creatinine and Urine routine analysis. Patients were started on Escitalopram (10 mg) + Etizolam (0.5 mg) daily for 30 days and others were not treated and acted as control; keeping the management of diabetes mellitus unchanged for all. Laboratory investigations were repeated after 30 days.

Results The prevalence of depression with/without anxiety was 35.2%. 51 patients treated with Escitalopram + Etizolam improved clinically and biochemically. There was a significant (P < 0.05) improvement in BSL-F and PP and HbA1C in patients treated with Escitalopram + Etizolam.

Conclusions Prevalence of depression among type 2 diabetes mellitus was found to be 35% in this study. Fifty one patients treated with escitalopram + etizolam improved clinically as well as biochemically. There was significant improvement in BSL-F, BSL-PP and HbA1c. Escitalopram may be considered as antidepressant of choice in such cases.